TRAUMA-INFORMED CARE FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DIFFERENCES

TRAUMA-INFORMED CARE FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DIFFERENCES

Presented by Karyn Harvey, Ph.D. kharvey@thearcbaltimore.org Materials at: Pid.thenadd.org Books at Amazon.com

Sources of Trauma for Individuals with IDD Report on Abuse of People with Disabilities 2013 Spectrum Institute Over 70% of people with Disabilities report being victims of abuse- 90% of them said it was on multiple occasions Only 37% reported the abuse to the authorities Sexual Abuse Hingsberger 8 out of 10 females sexually abused more than once with developmental disabilities Males 6 out of 10 Social Trauma Bullying, Name- calling, Verbal Abuse Psychology of Exclusion Stimulation of Anterior Cingular Cortex Trauma of Institutionalization, Foster-care Placements Trauma of Physical Abuse and Neglect Story of Joanne http://disability-abuse.com/

Bucharest Early Intervention Orphan Study 138 children between 6 and 31 months who were in an orphanage in Bucharest were studied 68 kept in institution 68 placed in a new foster care system full time paid parenting Results: After 54 months ( 41/2 years): Compared to 138 children raised in birth families http://www.unicef.bg/public/images/tinybrowser/uplo ad/ppt%20beip%20group%20for%20website.pdf

Issues: Institution Foster Care Biological Axis 1 Disorders Emotional Disorders Behavioral Disorders Intellectual Disability Average IQ Score 55% 35% 13% 49% 29% 8% 32% 25% 6.8% 73 85 110

MIRROR NEURONS: Interaction during infancy is needed for brain wiring

The New Face of Disabilities Abortion Rates On the decrease but latest report after prenatal diagnosis 67% Natoli et al. ( 2012) Fetal Cocaine Exposure More than 100,000 babies born in the United States annually are believed to have been exposed to cocaine or other drugs during the critical period of fetal brain development. Fetal Meth -amphetamine Exposure Combination of drug and alcohol exposure

Psychological Trauma past is present How did the brain react? Neocortex The rational brain: Intellectual tasks Limbic The intermediate brain: Emotions Reptilian The primitive brain: Self preservation, aggression The Triune Brain 8

Trauma Responses Due to Buttons Pushed Trigger Response Something happens in the present that reminds the person of the negative past - person goes into fight, flight or freeze mode: Thinking he or is in danger! Sometimes misinterpreted As Behavioral Trauma Trigger Fight Freeze Flight Attachment Issues

If you try to treat someone s illness without knowing its cause, you will only make the person sicker than before. Nichiren Daishonin

Ingredients Necessary for Post traumatic Recovery Perceived Safety Empowerment Connection

Trauma-informed Paradigm for Behavioral Interventions Traditional Approaches Managing Behaviors Providing contingent rewards shaming when not earned Power differentials Forced Choice Restraints Trauma- Informed Interventions Providing Emotional Safety Supporting choice Supporting relationships Facilitating Healing Empowering the individual Fostering a strong sense of self

Who Am I?

Positive Identity NOT the person who gets married NOT the person who drives NOT the person who plays on a high school sport team NOT the person who is popular or liked Not the cool one Development Negative Identity Positive Identity NOT the person who gets the job Who I am What I do well Who my friends are What my preferences are Where I make a difference What I am proud of From Victim to Victor!

What matters most is how YOU see yourself!

Ultimately happiness rests on how you establish a solid sense of self or being. Daisaku Ikeda

From Recovery to Happiness Seligman Flourish!" Five levels of Happiness: 1. Pleasure 2. Engagement 3. Positive Relationships 4. Achievement 5. Meaning *Happiness Assessment

REFERENCES Bennett, DS, Bendersky, M, and Lewis, M. (2008). Children s cognitive ability from 4 to 9 years old as a function of prenatal cocaine exposure, environmental risk and maternal verbal intelligence. Developmental Psychology, 44,(4) 919-28. Chasnoff, IS, Griffith, DR, Freier, C, and Murray, J. Pediatrics 89. Cocaine/Polydrug Use Pregnancy: Two Year Follow-up. (2) 284-9. 1992 Frank, DA, Augustyn, M, Knight, WG, Pell, T and Zukerman, B.( 2001). Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review. Journal of American Medical Association, 285, (12) 1613 Chiriboga, CA. ( 1998) Neurobiological Correlates of Fetal Cocaine Exposure Annals of NewYork Acadamy of Sciences,846, 109-125. Eisenberger, N, Lieberman, M., Williams, K. Does Rejection Hurt? An fmri Study of Social Exclusion in Science Vol 302, no 5643. Pp290-292. October 2003. Harvey, K. Trauma Informed Behavioral Interventions ( 2012) AAIDD Press, Washington. Harvey, K. Positive Identity Development ( 2009) NADD Press, Kingston. Herman, J. (1997).Trauma and Recovery. New York: Basic Books. LeDoux, J. (1996). The Emotional Brain. New York: Simon And Schuster. Chapter 8. Mercier F 1, Kwon YC, Douet V Hippocampus/amygdala alterations, loss of heparan sulfates, fractones and ventricle wall reduction in adult BTBR T+ tf/j mice, animal model for autism. 2012 Neuroscience 2 p 208-13. Seigel, D. (2009). The Mindful Therapist.New York: W.W. Norton and Company. Chapter 10. Seligman, M. Authentic Happiness. New York: Vintage Books. 2006.